About one quarter of total pharmaceutical spending in the commercial market is devoted to specialty medications. If current trends hold, spending on specialty medications may comprise half of all pharmaceutical spending by 2018 for commercial health care plans. These trends have invited the scrutiny of plan sponsors. To control spending, many payers and purchasers have established requirements for high cost-sharing, requirements that may trigger cost-related non-adherence for some patients.
This report by the V-BID Center and NPC outlines that: (1) for many patients and clinical indications, high spending on specialty medications is money well spent; (2) indiscriminate, high cost-sharing for specialty medications can be harmful to patients and employers; and (3) payers and purchasers can deploy a variety of tactics to help assure that patients have access to the right medications. Value-based insurance design (V-BID) is a key tactic payers and purchasers can use to promote access to high-value specialty medications.
Continue to full report at University of Michigan’s V-BID Center
Continue to video brief at YouTube